- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse - Case Management (FT/Days)Req #:0000179789 Category:Nursing Status:Full-Time Shift:Day Facility:Cooperman Barnabas Medical ... Road, Livingston, NJ 07039 Job Summary: The Case Manager Registered Nurse will coordinate discharge planning to...on other classifications of patients as designated by the Utilization /Case Management Review Plan. Coordinates… more
- RWJBarnabas Health (Livingston, NJ)
- Director ( Registered Nurse ), Case Management (Full-Time/Days)Req #:0000180556 Category:Leadership Status:Full-Time Shift:Day Facility:Cooperman Barnabas ... Department, including but not limited to clinical resource management , utilization review , discharge planning,...+ Current and valid license to practice as a Registered Nurse in the state of New… more
- NJM Insurance (Trenton, NJ)
- …years of prior experience in clinical nursing (Med-Surg or Critical Care preferred), Utilization Management Review /Hospital concurrent reviews, and/or Case ... comply with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review and medical management work. + Stay… more
- Molina Healthcare (New York, NY)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Fresenius Medical Center (New York, NY)
- …and FMS risk management initiatives. + Collaborates with the Clinical Coordinator/Charge RN or Nurse Supervisor to ensure the aggressive treatment of, and ... + Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the… more
- Fresenius Medical Center (Somerville, NJ)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Zufall Health Center (Somerville, NJ)
- …living with HIV/AIDS. In the model for MCM Nurse , the role is provided by a registered nurse ( RN ) and will focus on the clinical services of primary care ... Registered Nurse Case Manager Somerville, NJ...with program funding policies. The level of medical case management needed by the individual clients is determined by… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the ... responsible for managing a heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to provide each patient with the… more
- Northwell Health (Staten Island, NY)
- **Req Number** 144355 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
- Highmark Health (Trenton, NJ)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
- FlexStaff (New York, NY)
- …experience in care/case management , disease management , population health management , utilization review , quality assurance, or discharge planning ... intake clinical assessment, reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. An ideal candidate would… more
- Hackensack Meridian Health (Holmdel, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- Molina Healthcare (New York, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- Mount Sinai Health System (New York, NY)
- …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** ** RN /Case Manager MSH Case Management FT...Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or… more
- RWJBarnabas Health (Hamilton, NJ)
- …of Microsoft applications ex. Word ,Excel Preferred: + Utilization review and discharge planning experience + Case Management certification Certifications ... Inpatients to determine appropriateness of continued stay, care planning, utilization management and discharge planning. Required: +...and Licenses Required: + Current license as a registered Nurse in the State of NJ… more
- RWJBarnabas Health (New Brunswick, NJ)
- …Catheter Lab. The Director of the Cardiac Cath Lab and Physiology departments is a Registered Nurse ( RN ) with the knowledge, skill and competence in the ... Director, Cardiac Catheter Lab ( RN ) - New Brunswick, NJReq #:0000151612 Category:Nursing Manager...and appropriate coverage for operations + Directs all quality review functions and operations in the Department. This includes… more
- Penn Medicine (Plainsboro, NJ)
- …institution Credentials: + Basic Cardiac Life Support (preferred) + Registered Nurse - NJ (Required) + National Case Management certification preferred; or ... (LOC) managementPatient billing status managementDenials managementCMS Conditions of Participation Utilization review and Discharge planningData collection, auditing… more
- Molina Healthcare (New York, NY)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... and results across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing case management standards and processes and establishes… more
- Penn Medicine (Plainsboro, NJ)
- …graduate level education. . **_Related Work Experience_** + Previous experience working as a Registered Nurse . + Unit Budget We believe that the best care ... room, and Congestive Heart Failure Coordinator. This is a registered professional nurse responsible for visioning, overseeing,...+ Quality Improvement Plan + Unit budget + Resource Utilization + Human Resource Management + Master… more